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COMMENTARY |
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Year : 2015 | Volume
: 8
| Issue : 5 | Page : 678 |
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Concurrent leprosy and pulmonary tuberculosis
Viroj Wiwanitkit
Hainan Medical University, China; University of Nis, Serbia; Joseph Ayobabalola University, Nigeria; Public Health Curriculum, Surin Rajabhat University, Thailand; Dr. DY Pail Medical College, Pune, Maharashtra, India
Date of Web Publication | 10-Sep-2015 |
Correspondence Address: Viroj Wiwanitkit Wiwanitkit House, Bangkhae, Bangkok - 10160, Thailand
Source of Support: None, Conflict of Interest: None | Check |
How to cite this article: Wiwanitkit V. Concurrent leprosy and pulmonary tuberculosis. Med J DY Patil Univ 2015;8:678 |
The pathogenic Mycobacterium spp. infection is the present public health threat. The problem can be seen in any countries around the world. Of several members of Mycobacterium spp. infectious diseases, tuberculosis, and leprosy are the two most well-known medical disorders. These two diseases can be seen elsewhere, however, these infections are frequently seen in developing poor settings.[1] Despite several attempts to overcome Mycobacterium spp. infection, the diseases are still prevalent in many countries.
To combat with Mycobacterium spp. infection, the good diagnosis and prompt treatment is required. However, the reemerging of Mycobacterium spp. infection becomes the present issue. The present worldwide prevalent HIV infection leads to a difficulty to control Mycobacterium spp. infection.[2] An interesting issue is the concurrent infection between Mycobacterium spp. infection and HIV infection. This topic is widely discussed.[2] Nevertheless, another important issue that is less mentioned is the concurrent infection between two Mycobacterium spp. diseases. The concurrent leprosy and tubercuolosis is possible.[3] The present case report in Med J Dr. DY Patil Univ is a good case study.[4] In fact, as Mycobacterium spp. disease, both leprosy and tuberculosis share some common microbiological and pathological characteristics.[4] In fact, the co-presentation of leprosy and tuberculosis has been continuously reported in the literature.[4],[5],[6],[7]
According to a report from République Centrafricaine, Baquillon et al. noted that "the concurrent presence of endemic tuberculosis made it necessary during the survey to look for clinical associations of leprosy and tuberculosis in patients so that the standard multidrug treatment schedules comprising rifampicin could be adjusted accordingly".[8] Hence, it is no doubt that the physician in charge must think about and seek for possible concurrent infection in any patients diagnosed to be a case of leprosy or tuberculosis. An interesting report from India by Kumar et al. showed that 9 of 117 patients with leprosy have concomitant infection with pulmonary tuberculosis.[9] Kumar et al. noted that "it is important to recognise the presence of tuberculosis in leprosy patients so that proper therapeutic measures may be taken to avoid monotherapy of tuberculosis".[9] Sreeramareddy et al. mentioned that "clinicians should recognize corticosteroid treated leprosy patients as a population likely to develop concomitant tuberculosis".[7] Finally, it should be noted that not only a concomitant infection between classical dermatological case of leprosy and pulmonary tuberculosis, but also other pair of rare clinical presentations can be seen. The good example is "lepromatous lymphadenopathy and concomitant tuberculous axillary lymphadenitis".[10]
References | | |
1. | John TJ, Dandona L, Sharma VP, Kakkar M. Continuing challenge of infectious diseases in India. Lancet 2011;377:252-69. |
2. | Hussain T. Leprosy and tuberculosis: An insight-review. Crit Rev Microbiol 2007;33:15-66. |
3. | Gajwani BW, Verma BS, Marwaha RK, Pande RS. Simultaneous infection with M. tuberculosis and M. leprae. J Assoc Physicians India 1968;16:563-4. |
4. | Verma AK, Singh A, Prakash V, Bhatia A, Kant S. Coexistence of leprosy and tuberculosis: An uncommon entity. Med J DY Patil Univ 2015;8;5:675-7. |
5. | Negrete V, Ida J, Dillig G, Zohrabian N, Feldman J. Concurrent Hansen disease and pulmonary tuberculosis. J Am Acad Dermatol 2011;64:1001-3. |
6. | Loh E, Maverakis E, Konia T, Noll E. Lepromatous leprosy in a 26-year-old man with concurrent disseminated tuberculosis. Arch Dermatol 2012;148:1096-7. |
7. | Sreeramareddy CT, Menezes RG, Kishore P. Concomitant age old infections of mankind-tuberculosis and leprosy: A case report. J Med Case Rep 2007;1:43. |
8. | Baquillon G, Scandella B, Testa J, Desfontaines M, André J, Limbassa J. Leprosy survey conducted in the Central African Republic from 1982 to 1985 among the Ba-Benzele Pygmies. Acta Leprol 1992;8:71-8. |
9. | Kumar B, Kaur S, Kataria S, Roy SN. Concomitant occurrence of leprosy and tuberculosis — A clinical, bacteriological and radiological evaluation. Lepr India 1982;54:671-6. |
10. | Selvasekar A, Ebenezer GJ, Partheebarajan M. Lepromatous lymphadenopathy and concomitant tuberculous axillary lymphadenitis with sinus. A case report. Lepr Rev 1999;70:345-50. |
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